Renal cell carcinoma

Radiosurgery can be used very well for treating tumors on organs such as the kidney, as it is effective and gentle. Cyberknife radiosurgery has been used for many years and is well proven and safe for the treatment of kidney tumors, especially at the center of Munich. In close cooperation with the urological experts from the University Hospital of the LMU in Großhadern, cyberknife therapy is carried out on kidney tumors.

The cyberknife system can treat respiratory tumors on organs such as the kidneys without fixation or narcosis of the patient. Its special technology compensates for respiratory movements and is optimally designed to precisely hit the tumor with an accuracy of about one millimeter. The sensitive tissue in the kidney is optimally protected.

If patients who are at increased risk of surgery meet the indication criteria for radiosurgery, they can be treated very well with Cyberknife. For patients, usually only a single treatment session is necessary to effectively eliminate a tumor in the kidney. First data have already been published internationally (see publications).

Cyberknife for the treatment of renal cell carcinoma

In this article, we discuss the possibilities of Cyberknife treatment for renal cell carcinoma together with our experts from the Klinikum Großhadern at the University of Munich.

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Kidney cancer (renal cell carcinoma, also called renal carcinoma or adenocarcinoma of the kidney) is a malignant tumor that usually originates in the cells of the urinary ducts (tubulus system). This form is present in 95 percent of cases of kidney cancer. Usually only one kidney is affected. Very rarely, with just under 1. 5 percent, both kidneys become diseased. This is mostly due to genetic causes.

Kidney cancer is a relatively rare tumour disease. In Germany about 15,500 people develop this tumour every year, men are slightly more affected than women (as of 2012). Younger people tend to get the disease less frequently, especially kidney cancer is only diagnosed between the ages of 60 and 70. Renal cell carcinoma accounts for about three percent of all solid malignant tumours.

Kidney cancer very rarely causes symptoms at an early stage. However, if the tumor grows, pain in the flank and back may occur. Another indication of kidney cancer may be blood in the urine. Tumors of the kidney are rarely palpable. In men, a varicose vein fracture in the testicle may be caused by a kidney tumor.

If the symptoms or symptoms occur, such as unwanted weight loss, lack of appetite, tiredness, fever or anaemia, it may also be a sign of cancer.

Nowadays, kidney cancer is usually diagnosed at an early stage. Kidney tumours are often detected in the abdominal cavity during another examination by ultrasound. In order to detect a kidney tumor, various physical examinations and laboratory examinations are necessary. Imaging techniques such as ultrasound or computed tomography (CT) are also used.

Additional methods such as X-ray examination, magnetic resonance imaging (MRI) or skeletal scintigraphy (bone scintigraphy) may be necessary to obtain a reliable diagnosis and, if necessary, to determine the tumor’s spread, e. g. with bone metastases. If a kidney tumour is discovered at an early stage, the chances of a cure are usually good, but the prognosis for an advanced stage of the tumour is rather unfavourable.

Different methods are available for the treatment of renal cancer. If the tumour is confined to the kidney, the following treatment methods may be considered.


If kidney cancer is diagnosed, surgery has so far been the standard procedure. If the tumour is detected at an early stage and its size is limited or the other kidney is damaged or already removed, the operation is performed preserving the kidneys. This is referred to as a partial renal resection or partial nephrectomy. However, surgery usually involves the removal of the entire kidney, for example if the tumor has affected the entire kidney (simple nephrectomy). If there is a larger tumour, the cancer cells may also be present in the surrounding tissue. Then the adrenal glands and surrounding lymph nodes are also removed (radical nephrectomy).

Systemic forms of therapy Chemotherapy, drug therapy or immunotherapy

Several methods can be applied systemically in renal cancer. However, chemotherapy alone is not very effective in the case of a kidney tumour, as the tumours are often resistant to the drugs. Combination preparations must therefore be used to achieve treatment success. The therapeutic field can be expanded with available newer active substances or substances still in the testing phase. In the context of a drug therapy, so-called tyrosine kinase inhibitors can block the processes of multiplication and contribute to the regression of a tumour.

Active Surveillance

In the case of elderly patients, an active surveillance strategy may be chosen as an alternative to surgery in an early stage of the tumour under strict conditions such as age and concomitant diseases or life expectancy. However, in order to minimise the risk of uncontrolled tumour growth, close monitoring with imaging is necessary every three months. If the tumour increases due to sudden growth, the risks to the patient may increase.

Conventional irradiation

The cells of a kidney tumour are usually less sensitive to radiation than cells of other tumours. Conventional radiation therapy, which is often administered in fractional doses over several weeks, is therefore usually ineffective.


Radiosurgery is a very precise irradiation of the tumor with a usually single, high dose. A tumour is effectively destroyed by this very effective treatment method. Healthy surrounding tissue, on the other hand, is protected to the maximum. Scientific publications show the efficacy of treating kidney tumours with radiosurgery (e. g. Cyberknife). For patients, the radiosurgical method is comfortable as it is not burdensome.